Citizens tell Central Dispatch ambulance response times must get better

Emotions ran high at times, questions were plentiful, and explanations from officials were detailed at Clare County’s first Central Dispatch Committee meeting on Wednesday. But answers as to how slow ambulance response times — a common allegation leveled against Mobile Medical Response (MMR) in particular — might be improved seemed to be, at least at this initial meeting, in short supply.

Residents packed the Commission Chambers at the Clare County Building, looking to tell their stories, air their complaints, ask questions and offer suggestions. MMR, United Rescue (URS) and several townships all had representatives in attendance.

The meeting began with Gelios stating, “This committee is fact-finding,” noting that any recommendations the committee might reach would have to go before the Medical Control Authority Board, the 911 Advisory Board, the County’s legal advisor and, finally, before the full Board of Commissioners. Residents who had come to the meeting hoping for a quick resolution to their stated problems seemed a bit deflated by the weight of the process Gelios outlined, but were undeterred.

Yats explained how emergency services are dispatched. A minimum of two dispatchers are on duty at all times. “About 65 percent of the time, we’ve got three on,” Yats said. While the dispatcher who answers a call for assistance talks to the person making the call, Yats said that, as soon as it is determined what kind of assistance is needed (police, fire, and/or ambulance), the second dispatcher sends out a “tone” to what is determined to be the closest United Rescue ambulance, or forwards the information to the MMR dispatch system in Saginaw.

“We don’t have the capabilities to tone MMR. We do United,” Yats explained. After the closest ambulance is dispatched (which is required by law), Central Dispatch sends a tone out to those townships’ fire departments that have rescue services. In Clare County, that is Lincoln, Surrey, Freeman and Garfield townships, according to Yats.

Dale Majewski, Lincoln Township Fire Chief, explained that rescue personnel do not acknowledge the page until they reach the fire station. Since Lincoln Township’s fire department is staffed with volunteers, Majewski was asked how long it would take and how many medically trained people would need to be present to send the rescue vehicle. “We have to roll that rig with at least one state-licensed medical first responder,” Majewski answered.

Majewski said that he had 12 licensed medical rescue personnel in his department, but that response times would vary because some of his responders live close to the fire station and some live as far away as eight miles.

Yats explained that Lincoln Township was the only one that required his dispatchers to tone two towers, as the first tower did not reach the entire area. Five tones are sent out at two-minute intervals before another nearby rescue unit is called to respond, which was the protocol established with all fire departments in the County in 2007. Yats also said that updated information is relayed to ambulances as to the severity of the situation after they are dispatched.

Jason MacDonald, Director of Operations for MMR, said, “MMR does have direct two-way communication with Clare County Central Dispatch at all times via radio.” Emergency Management Director Becker explained that the old VHF system allowed all communications to be monitored, but since the system was upgraded to the 800 State’s trunk system, Central Dispatch cannot hear communications between the MMR ambulances and MMR’s dispatchers.

Several residents stepped forward to speak to the committee. Rhonda Reppert read a statement written by her husband John, who had written an introduction for the Independent Citizens for Ambulance & Rescue Efficiency (I.C.A.R.E.) packet presented to the Board of Commissioners on February 15, 2012.

Reppert’s statement said that he was “seeking resolution to the current situation in Clare County in regards to the ‘war’ between MMR and URS.” Reppert continued, “ I have not been involved with URS in any way. My concerns grow out of the information we have gathered since the untimely death of my brother-in-law.”

The two suggestions Reppert put forward was 1) that Clare County Central Dispatch handle all calls to 911 and not hand off the dispatching of MMR units to the center in Saginaw, and 2) that if a resolution between the parties could not be reached, the “Emergency 911 Service Establishing Act (Act 32 of 1986)” allows the State, upon request, to step in to resolve a dispute.

Reppert also cited the problem of streets and addresses being similar or duplicated throughout the County, and asked why the ordinance passed by the Board of Commissioners regarding road naming and address numbering was not being enforced.

Gelios replied that the ordinance applied to street names and address numbering from the time of the adoption of the ordinance forward, and was not retroactive to existing duplications. “There’s a statutory restriction and I’m reading from the State code, the State statute on the legislative authority of the county commission: ‘Counties shall not interfere with the local affairs of a township, city or village.’ That’s pretty clear. If they don’t want an ordinance to change their streets, we can’t force them to change those streets.” Gelios continued, “We can make a countywide ordinance that people can buy into, but we can’t force – and we don’t want to. They have their own elected officials.” Yats commented that there were 49 roads in the County with the same or similar names.

Judy Weber also addressed the committee, holding a framed picture of her husband Paul. Weber claimed that the ambulance sent to respond to her husband’s 911 call did not arrive in a timely fashion, got lost on the way, and needed her to give them directions to the hospital in Clare.

Weber also claimed that her sister, who had been an EMT in Gladwin County and who came to her husband’s assistance before the ambulance arrived, had told her after Paul’s death that “something went wrong with that call.”

“The citizens have to be informed,” Weber said. “You’re not being truthful and honest with people,” she said, turning to MacDonald.

Weber continued, “These things that are going on, they might not be legally wrong, but they are morally wrong. What is going on? I have had call after call after call to my home since we formed this [I.C.A.R.E]. I’m getting calls every day. Same thing – too long response time, ambulance got lost. Come on, people – all the same ingredients every time. Something is wrong.” Weber also complained that she had been unable to receive information from MMR regarding her husband’s case.

MacDonald replied that MMR is a private company and is not subject to Freedom of Information Act (FOIA) requests, which he claimed Weber had asked for. MacDonald said that HIPPA – the federal law that protects patient privacy – was preventing MMR from releasing information without a HIPPA form being filled out and submitted.

At times, the emotions of those who had lost loved ones led them to accuse MMR of not being forthcoming with information and lying about response times.

MacDonald, clearly upset with the allegations, replied, “I was born in this county. I live in this county. Several of us here live in this county. Our corporate headquarters are in Saginaw, absolutely. That’s where all of our data’s kept, that’s where everything’s kept. Yes, if you want to get private health information from a family member, you can go to Saginaw and pick it up, absolutely. But to imply that there’s no community here, that we’re not involved in the community is…,” MacDonald paused, “I take offense to that. I’ve served in this community for almost 25 years.”

MacDonald also said that the Saginaw center was “an accredited center of excellence. We are the only one in the State of Michigan. Keith [Yats] recognizes that; it’s a high distinction. Our dispatchers do it, they do it well, and they do it right, and it is fast. For 12 years, this system’s been in place. Your advisory board has had how many complaints regarding this process and this system? None. It works well, and it has worked well, and much of what I’m hearing today is based on misunderstanding, misinformation, and simply not knowing how it works.” MacDonald asked that committee members tour the Saginaw facility before making any decisions.

A man who identified himself as a retired fire chief from the Detroit area asked why MMR ambulances could not be required to keep Central Dispatch updated as to the progress of their response. Yats had indicated that MMR’s units did not generally communicate with Central Dispatch after they acknowledged that they were responding to an emergency call. The retired fire chief suggested that MMR advise Central Dispatch when they arrived at the site of the emergency, when they left the site, when they arrived at the hospital, and when they were finished delivering the patient and were ready to be put back in service.

Yats said that Central Dispatch handles over 40,000 911 calls a year, and that he is updating locating equipment for ambulances and addresses as quickly as the department can afford. Calls from a landline are given a site designation from AT&T information, Yats said, while cell phone calls – if it is a Phase 2 phone – are capable of locating a site via GPS latitude and longitude.

“I appreciate what I.C.A.R.E. is doing. Again, where I come from – and I’m a hometown guy here too – is that if we can increase or better a service to someone, then we need to look at those options. Again, funding is a big thing,” Yats said, adding, “We need to figure out a way to make it work that’s good for MMR, good for the County, Central Dispatch, the civilians. There is a way to make it work. We just have to figure out what that is and that takes working together instead of screaming at each other to figure out a solution.”

Near the end of the meeting, Board Chair Don David said, “Personally, I don’t take one side or the other. Jason MacDonald is my stepson and I’m very proud of him, and I think he does a great job doing what he does, but he and I don’t necessarily agree. And I made that statement publicly many times. But the Board doesn’t take any of this lightly; we’re doing everything we can to get to the bottom of every issue.”

After sitting quietly throughout the two-hour meeting, Peggy Major spoke softly, almost as if she was talking to herself. The meeting was over and people were milling around the room. Her son, Darwin Major, had suffered cardiac arrest at the Surrey Point gas station. The Surrey Township Fire Department report stated that CPR was performed by rescue personnel for 20 minutes before an MMR unit arrived from Mt. Pleasant.

“My son died,” she said, nearly in a whisper. Mrs. Major did not air a public complaint or make public accusations; rather, she seemed to be sitting vigil for all mothers whose sons were lost when maybe – just maybe – there was the slightest chance they might have been saved. Whether sitting quietly, like Mrs. Major, or with angry impassioned words, that is the essence of what those attending the meeting were asking for: a chance that others might not have to experience the same nagging questions and the same irreversible loss.

The next meeting of the Central Dispatch committee is scheduled for Thursday, March 29th at 10:00 a.m. The meeting is open to the public.